Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction.

Pleomorphic liposarcoma (PLS) is typically found in the lower and upper extremities. PLS arising in the gastrointestinal (GI) tract is extremely rare. Here, we reported a case of a 71-year-old female with a history of rectal adenocarcinoma presenting with small bowel obstruction. Small bowel resection was performed and revealed a 7.8 cm transmural mass in the jejunum. Histology reviewed a heterogenous epithelioid malignant tumor with intracytoplasmic fatty droplets scalloping the nucleus consistent with lipoblasts in some cells and others with numerous PAS/diastase+intracytoplasmic eosinophilic globules. Scattered multinucleated giant cells were also present. Mitotic count was up to 80/10 HPFs including some bizarre mitotic figures, and Ki67 proliferation index was approximately 60%. Immunohistochemistry demonstrated that the malignant cells were negative for pancytokeratin, CD117, DOG1, SMA, desmin, MyoD1, ERG1, CD34, CD31, SOX10, Melan A, and S100. INI1 was retained. Beta-catenin showed normal membranous staining. P53 was diffusely positive suggestive of mutant phenotype. Fluorescence in situ hybridization (FISH) assay was negative for MDM2 amplification and DDIT3 rearrangement. The overall morphologic and immunohistochemical features supported a diagnosis of high-grade pleomorphic liposarcoma. Diagnosis of PLS can be challenging due to its rarity in GI tract and lack of specific biomarkers, and histomorphology with identification of lipoblasts remains the gold standard.

Galen: The First Cardiac Surgeon?

It is widely believed that the first and the second pericardium surgeries were done in the nineteenth century by Francisco Romero and Dominique Jean Larrey, respectively; however, Galen was the first surgeon who proceeded with pericardiectomy. This ancient case report of sternum osteomyelitis and pericardiectomy illuminates some dark part of the history of medicine and the ability of physicians in that era.

SAND-FLY PHLEBOTOMUS PAPATASI (PHLEBOTOMINAE): A GENERAL REVIEW WITH SPECIAL REFERENCE TO ZOONOTIC CUTANEOUS LEISHMANIASIS IN EGYPT.

Leishmania are digenetic protozoa which inhabit two hosts, the sandfly where they grow as promastigotes in the gut, and the mammalian macrophage where they grow as amastigotes. Sandfly (or sand fly) is a colloquial name for any species or genus of flying, biting, blood-sucking Dipteran encountered in sandy areas. In the United States, sandfly may refer to certain horse flies that are also known as "greenheads" (family Tabanidae), or to members of the family Ceratopogonidae, also known in Florida and elsewhere as a sand gnat, sandflea, no-see-um (no-see-em, noseeum), granny nipper, chitra, punkie, or punky. Outside the United States, sandfly may refer to members of the subfamily Phlebotominae within the Psychodidae. Biting midges (Ceratopogonidae) are sometimes called sand flies or no-see-ums (no-see-em, noseeum). New Zealand sandflies are in the Austrosimulium genus, a type of black fly. Of 500 known phlebotomine species, only some 30 of them have been positively identified as vectors of the disease. Cutaneous leishmaniasis (ZCL) is a protozoan disease well documented not only in Egypt, but in nearly all the East Mediterranean Countries. It is prevalent in the Egyptian Sinai Peninsula with at least three identified foci.